Monthly Archives: January 2018

Repetitive transcranial magnetic stimulation (rTMS) is a novel, non-invasive method of activating neural signals through the use of strong, time-varying electromagnetic fields. rTMS is primarily used for patients with treatment-resistant depression. As its reputation has grown, so has its demand. But in the world of health economics and Return on Investment (ROI) ratios, is rTMS […]

Abstract The aim of this open study was to evaluate the safety and tolerability of theta-burst transcranial magnetic stimulation (TBS) and to assess preliminarily its therapeutic efficacy in patients with major depression. A total of 33 patients were assigned to receive one of four TBS protocols for 10 consecutive work days. TBS consisted of triple-pulse […]

Virginia Beach, Va. – Rana Culotta Simpson has suffered from depression most of her adult life. “I would sleep three days, at times 2-3 days not getting out of the bed,” says Culotta. This made it hard for the 35-year-old Peninsula resident to keep her job as a newspaper reporter. “I was socially anxious. I was phobic, paranoid. It was very hard to focus,” says Culotta. She`d tried antidepressants, but she wasn`t getting better. Eventually, she was placed on work disability. Then she found Dr. Katharine Heatwole at Ocean Psychiatric Group in Virginia Beach. It’s one of only 2 or 3 clinics in Hampton Roads treating patients with transcranial magnetic stimulation or TMS. “It’s pulse magnetic energy to the front left part of the brain, and that stimulates a little electrical current to the neurons or brain cells,” says Dr. Heatwole. “During my 1st treatment, I actually felt like there was someone tinkering or tapping on my head,” says Culotta. “That has a stimulation effect on the mood circuit so that it releases the neurotransmitters that are involved in mood,” says Culotta. “It is based on neuroplasticity and training the neurons to do what they are supposed to do in […]

By the time she was 61, Martha Rhodes had spent decades battling intractable depression. Diagnosis: treatment-resistant major depressive disorder. She’d tried a variety of medications to no avail; most were ineffective or caused nausea, diarrhea, weight gain and mood swings. During one particularly low evening in 2009, she attempted suicide. And every morning when she awoke, she experienced what she describes as “an emotional nausea – it was like this feeling of, ‘Why am I still here? Why do I have to be alive?’” But four years ago, Rhodes, now 65, of Danbury, Connecticut, underwent a procedure she says saved her life: repetitive transcranial magnetic stimulation, which uses magnetic pulses to electrically stimulate nerve cells in the brain and is used by doctors to relieve symptoms of depression. “My feelings of hopelessness, wishing I were dead and that life wasn’t worth living – all of that went away,” recalls Rhodes, who chronicled her experience with TMS in her 2013 book “3,000 Pulses Later.” Rhodes says she shares her story with others to demystify the treatment – which is often misunderstood by both patients and doctors, though it’s increasingly used by medical practitioners nationwide. What Is TMS? TMS was first developed […]

When you’re depressed, literally and figuratively stuck in a dark place, with no desire to get out and experience the world, it feels like time is inching by. Seconds feel like minutes, minutes feel like hours, and hours feel like days. Apparently, though, it’s not just a feeling. It’s a very real perception of time. New research from psychologists at the Johannes Gutenberg University of Mainz in Germany shows that depressed people actually experience time differently than healthy individuals. The scientists analyzed the results of 16 different studies examining 433 depressed subjects and 485 non-depressed control subjects. For the first part of the study, subjects were surveyed on their perception of time. “Psychiatrists and psychologists in hospitals and private practices repeatedly report that depressed patients feel that time only creeps forward slowly or is passing in slow motion,” reported study author Dr. Daniel Oberfeld-Twistel. The results of the meta-analysis confirmed that this is indeed the case. Then, for the second part of the study, they asked the subjects to subjectively estimate the length of a movie in minutes, press a button for five seconds, or identify the length of different sounds. In this case, the results obtained from the depressed […]

November 09, 2015 | Major Depressive Disorder [1], Depression [2], Transcranial Magnetic Stimulation [3] By Dee Rapposelli [4] RESEARCH UPDATE Repetitive transcranial magnetic stimulation (rTMS) is known to be a safe, noninvasive, treatment for major depressive disorder (MDD), but how does cost compare with that of pharmacotherapy? Australian researchers compared the cost-effectiveness of rTMS with pharmacotherapy in treatment-resistant patients with MDD (ie, those who have failed at least 2 courses of antidepressant therapy).1 They found that, although both pharmacotherapy and rTMS are clinically effective, rTMS is more cost-effective. Considering that up to 40% of patients with MDD either do not respond to or tolerate pharmacotherapy and that up to 85% of patients who do respond can be expected to relapse within 15 years, exploration of methods that more economically sustain quality of life is worthwhile. Although several studies have compared the cost of rTMS with that of electroconvulsive therapy, only one has compared the pharmacoeconomics of rTMS with that of pharmacotherapy for MDD.2 In that 2009 study, rTMS provides an incremental cost-effectiveness ratio of USD $34,999 per quality-adjusted life-year (QALY). (The willingness-to-pay threshold was set at USD $50,000 per QALY.) To further explore the issue, the Australian research team1 used a […]

By: Anita Roman POSTED:MAR 13 2017 09:26AM MST UPDATED:MAR 13 2017 09:30AM MST “The difference between pills and TMS is that TMS causes the nerves in the brain to fire as opposed to manipulating them with chemicals. What we found in patients with depression is the activity in their brain is low there are areas in the brain that activity are very low so the nerves are not firing activity.” [Read the Full Article Here]

BY NEWSWEEK SPECIAL EDITION ON 4/2/17 AT 2:10 PM This article is featured in Newsweek’s Special Edition: Nature’s Remedies—Heal Your Body. One of the leading causes of disability in the United States isn’t physical—it’s mental. According to the Anxiety and Depression Association of America (ADAA), 15 million adults—approximately 6.7 percent of the population—suffer from major depressive disorder, which is most often treated through a combination of talk therapy and medication. Those who struggle with depression have imbalanced levels of serotonin, which maintains mood, and dopamine, which controls the pleasure and reward zones. The brain’s synapses control how much of these chemicals are released, and drugs like Zoloft effectively prevent the little serotonin being produced from reabsorbing back into the nerve cells from which they were released, resulting in a higher concentration of serotonin. Some pill-averse patients have longed for a natural cure for depression, while others complain that the drugs they’re on aren’t enough. Hope for both groups may have arrived through an unlikely source: magnets. Researchers discovered they can harness the power of magnetism to increase serotonin production and combat depression through a process called Transcranial Magnetic Stimulation (TMS). “Each [symptom of depression] maps onto a given circuit of the brain,” […]

On Tuesday, Passion Pit’s Michael Angelakos went live on Facebook to share his experience getting a lesser-known noninvasive mental health procedure, transcranial magnetic stimulation (TMS), as a way of treating bipolar disorder. “The whole point is like, everyone says, ‘Oh, I don’t want to show people what I do, I don’t want to talk about therapy.’ If we don’t talk about it, it’s quite literally why no one understands what we’re talking about,” Angelakos said in his video. “So, I don’t have anything to hide. I think this is an amazing treatment.” The video, titled “This is what getting help looks like,” is almost an hour long, and features Angelakos and his doctor, “Bobby,” answering questions and providing information about TMS. All of this takes place while Angelakos undergoes treatment. “I’m manic right now, I’ve not slept in three days,” Angelakos shared. “I’m tired, but not at all. I talk a lot. Ideas are kind of just going, going, going, going, and I need to calm down. Sometimes I take lithium, I would prefer to do this. This helps calm me down.” [Read the Full Article]

Jo Duff had only left home a few minutes earlier. She was driving in familiar territory but suddenly she had no idea where she was. The houses looked strange. The local hotel was foreign. Unable to recognise any landmarks, she felt completely lost. “It was quite unnerving,” she said. “My mind just went blank, I didn’t know where I was.” She phoned her husband, Bill, who was playing golf. He asked if she was near North Road, the closest main road to their house. But she wasn’t sure. “That made me very worried because she’s driven down there a hundred times,” he said. Within a few weeks, the scenario repeated itself. It was enough to prompt Bill to mention it to his neurologist, who thought it was worth investigating further. After a series of scans and tests, Jo was diagnosed with mild to moderate Alzheimer’s disease. But two years on, she hasn’t experienced the deteriorating mental capacity associated with the condition. Instead the 78-year-old is able to remember things she couldn’t previously. The fogginess that had muddled her head, blocking names and dates from being retrieved, had lifted. Jo puts it down to the transcranial magnetic stimulation, or TMS, she […]

The FDA recently granted 510k clearance to market MagVita TMS therapy, a repetitive transcranial magnetic stimulation system, for treatment of depression. “The new FDA cleared MagVita TMS Therapy system is tailor-made for health care professionals seeking an entry-level TMS system without having to compromise on quality and safety,” Kerry Rome, BS, vice president of sales at MagVenture Inc, said in a press release. The MagVita TMS therapy system was first cleared by the FDA in 2015 for treatment of major depressive disorder. [Read the Full Press Release Here]

Analysis of FAERS data finds less comorbid depression among pain patients on ketamine by Neel A. Duggal Contributing Writer, MedPage TodayMay 12, 2017 An analysis of data from the FDA Adverse Events Reporting System (FAERS) supported previous findings that ketamine could be an effective treatment for depression, researchers found. Given financial and ethical obstacles to a large randomized controlled trial of ketamine for depressive disorders, Ruben Abagyan, PhD, of the University of California San Diego, and colleagues decided to turn to AERS data on patients taking ketamine for pain, an FDA-approved use. They found that patients who took ketamine had significantly lower frequency of reports of depression than those taking any other drugs for pain, according to findings published in Scientific Reports. “This reduction in depression is specific to ketamine and is known to be much more rapid than current antidepressants, making this observed effect very promising for treatment of patients with acute depressive or suicidal episodes,” Abagyan and colleagues wrote. [Read the Full Article Here]

Friday, May 05, 2017 Lisa Salmon Have you heard of TMS? It stands for transcranial magnetic stimulation and, according to reports, could offer hope to people with clinical depression when other treatments haven’t helped. It was invented in Sheffield the 1980s and has been used to treat a number of mental and physical health conditions, including OCD, anorexia, tinnitus and fibromyalgia — but studies suggest up to 70% of people with clinical depression could benefit from it. Treatments usually centre around talking therapies, such as cognitive behavioural therapy (CBT) and antidepressant medicines. For severe depression that hasn’t improved with other treatments, electroconvulsive therapy (ECT), where an electric current is applied to the brain under general anaesthetic, is sometimes used. “TMS is a much more acceptable intermediary treatment between medication and ECT,” says consultant psychiatrist Dr Leigh Neal, medical director of the Smart TMS clinic in London. “It involves a sea change of how we’ll treat people in the future and the outcomes for depression.” HOW DOES IT WORK? TMS simply involves a magnetic head, which converts electricity into a magnetic field, being placed against the scalp. The magnetic field sets up electrical circuits in the brain, affecting only a tiny […]

Thetaburst Stimulation in 2017 This article from 2015 published by CTV News gives a good overview of TBS Stimulation and the exciting effect the treatment was having on patients with depression. Now, in 2017, the TMS Center of Southwest Florida is thrilled to offer both TMS and TBS treatment options for our patients. For more information please call: 888-491-4171. * * * * * * * * * * * Jesse Tahirali, CTVNews.ca Published Sunday, January 25, 2015 10:10PM EST The grey clouds of depression are difficult to shake. Approximately eight per cent of Canadian adults will experience a major depression at some point in their lives, according to Toronto’s Centre for Addiction and Mental Health. Medication often fails to temper the debilitating effects of the illness. Only one third of patients report improvement after their first round of treatment, and some fail to improve regardless of what they’re prescribed. Gail Bellissimo, a Mississauga mother of four, was one of those people who still suffer even after seeking help. “I tried just about every drug out there, antidepressant of all kinds,” Bellissimo said. “They just either didn’t work for me or the side effects were too much for me to take.” […]

LOS ANGELES, July 11 — Doctors in California say magnetic stimulation can help ‘rewire’ the brains of people withdepression, offering hope for patients whose condition is not improved by medication or therapy. Depression is one of the most common forms of mental illness, affecting more than 350 million people worldwide. Bob Holmes is one of them. “I struggled with that for many years, didn’t know really what to do, tried to pull myself through it. And then ultimately when I got into my forties, I wasn’t successful.” Holmes has been receiving transcranial magnetic stimulation at the University of California Los Angeles, a treatment that beams targeted magnetic pulses deep inside his brain. Doctors say the therapy can effectively ‘rewire’ the brain by changing how brain circuits are arranged. Reuters Video: Doctors hope to ‘rewire’ depressed people’s brains: [Read the Full Article Here]

More than 15 million Americans suffer from depression, and more than a third of them don’t respond to counseling or antidepressants. Nathalie DeGravel was one of the unlucky ones—until she discovered a novel new therapy. Four years ago, Nathalie DeGravel, 48, finally recognized something was horribly wrong with her brain. A human resources coordinator at the time, and living in Los Angeles, she knew that the episodes of rage and crying she battled frequently were much worse than the typical emotions everyone experiences. But her trips to a psychiatrist and prescription medications couldn’t put a dent in the vicious depression she was suffering. Her despair at finding a solution led her to an unconventional new treatment—which ended up saving her life. Born in Paris, France, DeGravel had always been content with the pleasant life she built in the United States: A husband and two children she enjoyed immensely, a satisfying career, with occasional trips to visit family in Paris. When her symptoms of depression began, they were mild, almost unnoticeable. Over time, however, the mental illness grew in severity to the point she couldn’t even recognize herself, or the life she had worked so hard to build. … […]

By Meredith WadmanAug. 29, 2017 , 3:30 PM Luca Rossi tried to hang himself in a bedroom in Perugia, Italy, in 2012. Suspended by his belt from a wardrobe, he had begun to choke when his fiancée unexpectedly walked in. He struggled to safety, defeated even in this intended last act. The 35-year-old physician had everything to live for: a medical career, plans for a family, and supportive parents. But Rossi* was addicted to crack cocaine. He had begun his habit not long after medical school, confidently assuming that he could control the drug. Now, it owned him. Once ebullient and passionate, he no longer smiled or cried. He knew he might be endangering his patients, but even that didn’t matter. He was indifferent to all except obtaining his next fix. “It pushes you to suicide because it fills you with your own emptiness,” he says. In the first months after his near suicide, Rossi didn’t drop his $3500-a-month habit. Early in 2013, he learned that his fiancée was pregnant. Frightened by impending fatherhood, he smoked even more. He didn’t—couldn’t—stop. Then, in April 2013, Rossi’s father, a chemist, happened upon a local newspaper article describing work just published in Nature. […]

A Study from Würzburg University Hospital Shows TMS May Help Alleviate Anxiety It is possible to unlearn fears. And this works even better when a specific region of the brain has previously been stimulated magnetically. This has been shown by researchers from the Würzburg University Hospital in a new study. Nearly one in seven Germans suffer from an anxiety disorder. Some panic upon boarding an aircraft, others find it impossible to enter a room with a spider on the wall and again others prefer the staircase over the elevator – even to get to the tenth floor – because riding in elevators elevates their heart rate. What sounds like funny anecdotes is often debilitating for the sufferers. Sometimes their anxiety can affect them to a point that they are unable to follow a normal daily routine. But help is available: “Cognitive behavioural therapy is an excellent treatment option,” says Professor Martin J. Herrmann, a psychologist at the Center of Mental Health of the Würzburg University Hospital. This form of therapy deliberately exposes anxiety patients to the situations they feel threatened by – under the individual psychological supervision of an expert. Brain stimulation improves response However, current studies have shown that this […]

Published Thursday 26 October 2017 By Tim Newman Fact checked by Jasmin Collier According to a recent study, although treating major depressive disorder has benefits in the short-term, over a longer period of time, it may make the condition worse. Major depressive disorder is a serious, debilitating mental illness. In the United States, it affects more than 16.1 million people over the age of 18. Although its prevalence is high, it is still a difficult condition to treat. Treatments include medications such as selective serotonin re-uptake inhibitors and talking therapies, such as cognitive therapy. No case of depression is the same, and often, individuals receive a range of treatments across their lifetime. How well the treatment of depression works has come under scrutiny over recent years, and the debate is by no means over. The latest study, published in the journal Psychotherapy and Psychosomatics, adds another dimension to this ongoing conversation. Clinical Treatment Compared with Community Individuals with major depressive disorder who receive medication or cognitive therapy often see a reduction in their depressive symptoms and experience significantly longer times before relapse. But over the longer-term, the picture is less clear. This is primarily because studies generally only run for […]

John Foster, like many who have served our country, has dealt with the lasting effects of war, especially post-traumatic stress disorder (PTSD). The 38-year-old says a genetic test, ordered by his doctor, helped guide his treatment plan and allowed him to get better, faster. The Orlando, Florida, resident was a combat medic and served two tours of duty in Iraq. He says the first tour, in 2004 and 2005, left him with no problems…or so he thought. It was during the second tour, in 2006 and 2007, when his issues developed. This is when the Army extended tours as a part of the troop surge. During John’s deployment, 11 members of his unit were killed in the deadliest year of the war on terror. Foster’s PTSD has required both inpatient and outpatient treatment. Through the years, he’s dealt with the frustration of discovering that many psychiatric drugs don’t work for him: at one point taking as many as 13 different medications a day. “My doctor, Dr. Robert Pollack, was able to adjust my meds and recommend supplements to more effectively help me deal with the situation…the Genecept Assay® was key for me to help unlock the personal information that I […]

Publish date: December 14, 2017 By Randy Dotinga Clinical Psychiatry News SAN DIEGO – High-potency marijuana use appears to be associated with an increased risk of a first psychotic episode, based on a case-control study conducted in Europe. “Daily users of a strong type of cannabis face a significant increase in the probability of developing a psychotic disorder,” reported Marta Di Forti, MD, PhD, MRC, lead author of a study whose preliminary results were presented at the International Congress on Schizophrenia Research. Dr. Di Forti spawned a media boomlet in 2015 when she and her colleagues raised the prospect of a possible association between so-called “skunk” marijuana and first psychotic episodes. In their study of subjects in London with first-time psychotic episodes and matched population controls, those who had psychotic episodes were three times (adjusted odds ratio: 2.92; 95% confidence interval, 1.52-3.45; P = .001) as likely as controls to have used “skunk” marijuana (Lancet Psychiatry. 2015 Mar;2[3]:233-8). In the new study, Dr. Di Forti and her colleagues analyzed 1,200 first-incident cases of psychosis that were captured between the years 2010 and 2013 by the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions project (EU-GEI). The researchers compared the cases to 1,300 population-based controls in […]

Question: How do effects of genetics and rearing each contribute to the transmission of risk for major depression from parents to children? Findings: In this population register–based study of 2 269 552 offspring of intact, adoptive, not-lived-with father, stepfather, and triparental families from the general Swedish population, the effects of genes and rearing were approximately equal for parent-offspring resemblance for major depression. Genetic and rearing effects acted additively on offspring risk for major depression. Meaning: Genetic and rearing effects are important in the cross-generational transmission of major depression. Importance Twin studies have assessed sibling resemblance for major depression (MD) but cannot address sources of resemblance across generations. Objective To clarify the relative importance of genetic and rearing effects on the parent-offspring resemblance for MD. Design This Swedish population register–based study examined parents and children from the following 5 family types: intact (2 041 816 offspring), adoptive (14 104 offspring), not-lived-with (NLW) father (116 601 offspring), stepfather (67 826 offspring), and triparental (29 205 offspring). The 5 family types permitted quantification of parent-offspring resemblance for genes plus rearing, genes-only, and rearing-only associations. Treated MD was assessed from national primary care, specialist care, and inpatient registries. Data were collected from January 1, 1960, through […]

Abstract The aim of this open study was to evaluate the safety and tolerability of theta-burst transcranial magnetic stimulation (TBS) and to assess preliminarily its therapeutic efficacy in patients with major depression. A total of 33 patients were assigned to receive one of four TBS protocols for 10 consecutive work days. TBS consisted of triple-pulse 50-Hz bursts given at a rate of 5 Hz to the left or right dorsolateral prefrontal cortex at different stimulation parameters. Severity of depression was assessed by the Hamilton Depression Rating Scale. Our results indicate that TBS as applied in this study is safe and well tolerated in depressed patients and seems to have antidepressant properties. Increase of stimulation parameters is not associated with more side-effects and adds to its therapeutic effect. Introduction In the last two decades, repetitive transcranial magnetic stimulation (rTMS) has been studied as a therapeutic tool in several neuropsychiatric disorders, primarily for the treatment of major depression (MD) where it has shown a consistent and reproducible therapeutic effect (Feinsod et al.1998; George et al.1997, 1999; Pascual-Leone et al.1996). Previous studies have demonstrated that left high-frequency (⩾5 Hz) (George et al.2000) and right low-frequency (⩽1 Hz) (Klein et al.1999) rTMS to the prefrontal cortex (PFC) is effective in […]

Repetitive transcranial magnetic stimulation (rTMS) is a novel, non-invasive method of activating neural signals through the use of strong, time-varying electromagnetic fields. rTMS is primarily used for patients with treatment-resistant depression. As its reputation has grown, so has its demand. But in the world of health economics and Return on Investment (ROI) ratios, is rTMS a viable option for the millions of people suffering from depression? To date, no such analysis has examined the cost-effectiveness of rTMS as a first line or at least an earlier treatment option over a patient’s lifetime. To investigate this question, Voight and Leuchter (2017) used Markov simulation modeling to analyze direct costs and quality adjusted life years (QALYs) of rTMS versus medication therapy in patients with newly diagnosed Major Depressive Disorder (MDD) who were age 20-59 and had not improved after a single pharmacotherapy trial. Response and remission rates, quality of life outcomes and life expectancy were culled from the scientific literature. The baseline for treatment costs was derived from federal Medicare reimbursement data. Additional baseline data included QALYs, assessment of superiority, analysis of instrument sensitivity, and lastly, a discount rate of 3% was applied. The results of this complicated health/economic analysis revealed the […]

Melissa Banks says she struggled with depression “on and off, but mostly on” since the age of ten. She traces the cause to early life experiences, and while she doesn’t have a personal recollection of the details, her mother has helped fill the gaps in her memory.“My twin brothers were born when I was not quite two,” Melissa shares. “My life until that point had been great. I was part of a young family, was the first daughter and everything was wonderful. Then, when my brothers were born, my mom suffered from postpartum depression. She now had three kids under two. One had food allergies, which they didn’t know anything about in 1974. “My physical needs got met, but attention and affection were pretty much withdrawn at that age,” Melissa continues. “And then my parents split up when I was nine and divorced when I was ten.” Melissa’s mother was busy with a full-time job 30 miles from home, and then with her pursuit of a Master’s degree at a college 120 miles away. Melissa took care of her brothers and kept house. “I was a stay-at-home mom when I got home from school,” she remarks. “I never really felt […]

DEPRESSION IS VERY REAL. BUT THERE IS HOPE.

TMS is considered an effective treatment option that reduces the symptoms of certain neurological conditions in adults.

It is also often prescribed to patients who have not improved with traditional treatments. This includes patients who have not benefited from medication or psychotherapy. However, TMS is increasingly being seen as a first line treatment, and more doctors are prescribing TMS Therapy before prescribing medications or alongside medications.

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